<mediadc-video-embed data-state="{"cms.site.owner":{"_ref":"00000161-3486-d333-a9e9-76c6fbf30000","_type":"00000161-3461-dd66-ab67-fd6b93390000"},"cms.content.publishDate":1665770235518,"cms.content.publishUser":{"_ref":"0000017a-8cb2-d416-ad7a-beb7278f0000","_type":"00000161-3461-dd66-ab67-fd6b933a0007"},"cms.content.updateDate":1665770235518,"cms.content.updateUser":{"_ref":"0000017a-8cb2-d416-ad7a-beb7278f0000","_type":"00000161-3461-dd66-ab67-fd6b933a0007"},"rawHtml":"
var _bp = _bp||[]; _bp.push({ "div": "Brid_65755743", "obj": {"id":"27789","width":"16","height":"9","video":"1117525"} }); ","_id":"00000183-d7a4-d791-abd3-dffda16f0000","_type":"2f5a8339-a89a-3738-9cd2-3ddf0c8da574"}”>Video EmbedThe Washington Post is very worried that there are too many Catholic hospitals.
Catholic hospitals, being Catholic, don’t abort the babies who come in through their doors. The people quoted in that Washington Post piece seem to think that they have a right to force Catholic hospitals to abort babies. It’s bizarre and intolerant.
The most charitable reading of the story, though, is that it’s not objecting to the existence of Catholic hospitals that are actually Catholic, but it’s lamenting that Catholic hospitals are a growing share of hospitals.
Sandwiched between dark warnings about Creeping Sharia Catholic Doctrine, the Washington Post piece mentioned “consolidation in the hospital industry, as financially challenged community hospitals and independent physicians join bigger systems to gain access to electronic health records and other economies of scale.”
This consolidation is a real and important dynamic in healthcare. And it’s not great.
Kaiser Health News has a story today on consolidation and the squeeze on smaller providers.
Consolidation is bad, the story pointed out: “A 2012 report from the Robert Wood Johnson Foundation found that when hospitals merge in highly consolidated markets, price increases often exceed 20%.”
On a more human level, “The loss of independent physician practices threatens to fundamentally reshape the historical relationship between doctors and patients as more doctors become beholden to their employers instead of the people they treat.”
One culprit, identified by Kaiser Health News: “billions of dollars in federal aid at the beginning of the crisis favored large hospital systems.”
But that’s not the only way Big Government has caused hospital consolidation. Obamacare played a huge role.
“The Affordable Care Act did not start the consolidation rapidly occurring with hospitals/health systems and medical groups,” one article in a medical journal said. “But it most definitely accelerated the movement to combine.”
Piles of regulations and subsidies add to the cost and complexity of doing business, and for that basic reason, Obamacare drove consolidation. But Obamacare also specified that hospitals get paid more than non-hospitals for the same procedures.
Scott Gottlieb explained last decade that provider consolidation is the “outgrowth of a deliberate industrial policy set in motion by changes in the way healthcare is being organized and reimbursed.”
Specifically, Obamacare “contains deliberate constructs to industrialize healthcare by moving physicians into capitated arrangements and larger groups where reimbursement, utilization, and quality measures can be more tightly controlled. These arrangements have many champions but also carry significant uncertainty.”
Obamacare authors wanted providers to consolidate into fewer and bigger hospitals. They found that arrangement preferable.
Always remember that the American Hospital Association supported Obamacare. Obamacare’s defense attorney, Donald Verrilli, went to work for the American Hospital Association. Bob Dole, a hospital lobbyist, was the most prominent Republican supporting the bill.
State governments explicitly bar hospital competition in a lot of places through “certificate of need” laws. In short, regulators won’t allow a hospital unless they think one is needed, and if a hospital is already nearby, then a new one isn’t needed, the regulators conclude. Matt Mitchell last year reported that 35 states have such laws.
Big hospitals like having less competition. Big Government seems to like that, too. If the Washington Post’s editors and reporters are worried about the spread of Catholic hospitals, they should expose how Obamacare and our COVID-19 response are driving other providers out of business.
